S60 Poster sessions / Patient Education and Counseling 34 (1998) S57 –S81

guideline? And who can stimulate the transfer of results Teaching communication for the implementation ofof the training to the workplace? clinical pathways: reflections on coaching and consult-In this poster these two questions will be addressed. ing to the processThe guideline will be introduced briefly. Participants will

Mary Hardy, Helen Meldrum (a). (a) Massachusetts Coll.be actively involved in sharing their own experiences and

of Pharmacy & Allied Health, 179 Longwood Ave.solutions. A review will be given of the outcome of two

02115 Boston Massachusetts, USA.case studies. These studies involved close monitoring ofthe implementation process of the guideline in two Working as collaborative partners, (a physician and acommunity care organisations in the Netherlands, during professor of psychology and communication) we havea period of 18 months. extensive experience in consulting to hospitals, managedThe poster is of interest for health care workers, mana- care organizations and professional associations in theirgers, and trainers. efforts to develop critical guidelines. The initiation of

similar quality improvement projects is already wide-spread in health care organizations across the UnitedIntegrated Health Care: A CurriculumStates. The formation of these teams is sometimesvoluntary but more often mandated. It appears that

Mary Hardy, Kate Dolben. 3325 Wrightwood Drive, CA because of accumulated resentments stemming from past91604-3939 STUDIO CITY, USA. organizational interventions that may have lacked clear

goals (e.g. ‘Total Quality Management’), participantsoften have a great deal of justifiable cynicism that mustThe need to honor medicine as both art and sciencebe addressed when they are recruited into a guidelinesredefines communication in health care.project.The science of communication is the conveyance of unitsWe have developed educational programs to equip andof information across a distance, intact.motivate participants to arise to the challenge of develop-The art of communication is the representation of ex-ing, implementing and maintaining a guidelines project.perience and the exploration of meaning; a unit ofBecause the response of health care professionals reflectsinformation expressed may have little direct relationshipthe level of ‘‘buy-in’’ that they feel, we created exercisesto the experience of meaning received.to teach the necessary communications skills to everyoneFrequently, the health care provider and the patient talkfrom the devoted to the doubtful. For example, someat cross purposes, across world views; oftentimes keyproviders simply need help with Retention while othersstatements or cues in the patient’s communication are ]must be Re-educated. Reluctance is often an issues as ismissed or dismissed. ] ]outright Resistence. Rigidity and Radical AbsolutismAt Teaching about Communication in Medicine, (Oxford, ] ] ]must be reduced before much progress can be made.July 1996), we outlined a health care provider-patientThus we prepare the formal and informal leaders tointeraction which would recognize the differences indismantle a hierarchy of attitudinal barriers. To pursueworld views, areas of concern and responsibilities of boththese goals we teach skills for defusing negativity,the health care provider and the patient. The recognitionasserting interests responsibly, using influence strategiesof these differences became the basis for strategies forin an ethical manner and clarifying goals to reachbridging and negotiating them.consensus. Our presentation /workshop will be focusedSubsequently, we ran a pilot program, Integrated Healthon sharing our teaching materials and inviting furtherCare part I - The Interview, a Selective at the Universitydiscussion on how teaching skills can increase theof Southern California School of medicine. In this courseprobability of successful implementation of guidelinewe stressed the need for a dialogue between health careprojects.provider and patient, known and unknown, fact and

mystery, physician’s assessment and patient’s reality. We The development of a comprehensive assessmentused the concept of a Multiple Axis of Domain, Diag- system for a communication skills course for under-nosis and Intervention to develop skills for bridging areas graduate medical studentsof concern and responsibilities and the gap between

G.M. Humphris (a), S. Kaney, L. Davidson. (a) Univ. ofworld views. We used the Multiple Axis as a clinical

liverpool, Dept. of Clinical Psychology, The Wehlanpathway to develop strategies to enhance communication

building, Quadrangle, Brownlow Hill, L69 3GB Liver-(transfer of information and creation of understanding)

pool, UK.between health care provider and patient.

Introduction. Curriculum change in undergraduate medi-Integrated Health Care: A Curriculum will review thecal courses has gathered pace in the UK over the paststrategies, content and conclusions of Integrated Healthfew years following pronouncements of the GeneralCare - The Interview, and invite discussion of theMedical Council. Assessment is a vital component astechniques and practices of a new curriculum.